Why Is My Face Tingling Around My Mouth?

Face tingling can be caused by anxiety, hyperventilation, panic disorder, low calcium level (hypocalcemia), shingles, Bell's palsy, myofascial pain syndrome, hyperparathyroidism, and abnormal nerve sensations

Tingling in the face around the mouth can be caused by a number of conditions ranging from anxiety disorders to nerve sensations. 

Common causes of face tingling include: 

• Hyperventilation
• Panic disorder
• Low calcium level (hypocalcemia)
• Shingles
• Bell's palsy
• Myofascial pain syndrome
• Hyperparathyroidism
• Abnormal nerve sensations:
  • Paresthesia describes abnormal burning or prickling sensations 
    • Temporary paresthesia (“pins and needles” feeling) that can occur, for example, if a person falls asleep with the face pressed against a pillow in an unusual way; the sensation goes away when the pressure is relieved
    • Chronic paresthesia can be a symptom of an underlying neurological disease or traumatic nerve damage
      • Stroke and transient ischemic attacks (TIAs, or mini-strokes)
      • Multiple sclerosis (MS)
      • Transverse myelitis
      • Encephalitis
      • Tumors or vascular lesions in the face, brain, or sinuses 
  • Dysesthesias are types of chronic nerve disorders caused by nerve damage
    • Feels like prickling, burning, stabbing, ice cold, or electrical sensations
    • May be caused by:
      • Autoimmune disorders
        • Multiple sclerosis
        • Acute inflammatory demyelinating polyneuropathy 
      • Diabetes
      • Lyme disease
      • Drug or alcohol withdrawal
      • Certain types of stroke (thalamic infarct)
      • Alcohol or drug withdrawal
      • Chemotherapy

Symptoms that can accompany face tingling around the mouth depend on the cause and may include: 

• “Pins and needles” sensation 
• Numbness
• Itching
• Skin crawling
• Prickling
• Stabbing
• Burning
• Electrical sensations
• Ice cold
• Cold feels hot or hot feels cold 
• Pain with only light touch
• Anxiety
• Skin rash or other skin changes
• Tightening muscles of the neck and shoulders
• Headache
• Congestion

8 Stroke Symptoms

Signs of a stroke or transient ischemic attack (TIA) are a medical emergency. Seek medical care immediately if you experience face tingling around the mouth and: 

• Numbness or tingling of the face that occurs suddenly
• Facial drooping and/or uneven smile
• Blurred vision
• Sudden loss of vision
• Arm weakness or numbness
• Leg weakness or numbness
• Trouble walking
• Speech difficulties or slurred speech

The cause of face tingling around the mouth is diagnosed based on a medical history and a physical examination, and after skin (dermatological) disease has been ruled out.

Blood tests to diagnose causes of tingling in the face may include:

• Angiotensin-converting enzyme (ACE)
• Antibodies to Borrelia burgdorferi (found in Lyme disease)
• Antineutrophil cytoplasmic antibodies (ANCA)
• Antinuclear antibody (ANA)
• C-reactive protein (CRP)
• Complement (C3, C4)
• Electrolyte levels (includes calcium)
• Glycosylated hemoglobin (HBA1c)
• Heavy metal levels
• Human immunodeficiency virus (HIV) 
• Iron, folate, vitamin B12, vitamin E
• Viral hepatitis

Other tests to diagnose causes of face tingling around the mouth may include:

• Cerebrospinal fluid (CSF) analysis 
• Magnetic resonance imaging (MRI) scan 
• Computerized tomography (CT) scan 
• Nerve conduction studies 
• Skin biopsy
• X-rays 

Treatment for face tingling around the mouth depends on the cause and the severity of symptoms.

Medications to treat face tingling around the mouth depend on the cause and may include:

• Local numbing (anesthetic) patches
• Capsaicin cream
• Antidepressants
• Antiepileptics 
  • Carbamazepine
  • Gabapentin
  • Pregabalin
• Antipsychotic medications 
  • Pimozide
  • Venlafaxine
• Anti-anxiety medications
• Propranolol
• Cannabinoids 

Other treatments for face tingling around the mouth depend on the cause and may include:

• Physical barriers to reduce scratching and rubbing, such as gloves, night-time thermoplastic facemask, and night-time arm splinting
• Botulinum-A injections 
• Transcutaneous electrical muscle stimulation (TENS)
• Physiotherapy
• Narrow-band ultraviolet radiation
• Intralesional steroid injections